tailieunhanh - Báo cáo y học: "arly development of non-hodgkin lymphoma following initiation of newer class antiretroviral therapy among HIV-infected patients - implications for immune reconstitution"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Wertheim cung cấp cho các bạn kiến thức về ngành y đề tài: arly development of non-hodgkin lymphoma following initiation of newer class antiretroviral therapy among HIV-infected patients - implications for immune reconstitution. | Huhn et al. AIDS Research and Therapy 2010 7 44 http content 7 1 44 AIDS RESEARCH AND THERAPY SHORT REPORT Open Access Early development of non-hodgkin lymphoma following initiation of newer class antiretroviral therapy among HIV-infected patients - implications for immune reconstitution 34 2 2 Gregory D Huhn 1 Sheila Badri 1 Sonia Vibhakar Frank Tverdek Christopher Crank Ronald Lubelchek 1 2 2 2 2 Blake Max David Simon Beverly Sha Oluwatoyin Adeyemi Patricia Herrera Allan Tenorio Harold Kessler David Barker1 2 Abstract Background In the HAART era the incidence of HIV-associated non-Hodgkin lymphoma NHL is decreasing. We describe cases of NHL among patients with multi-class antiretroviral resistance diagnosed rapidly after initiating newer-class antiretrovirals and examine the immunologic and virologic factors associated with potential IRIS-mediated NHL. Methods During December 2006 to January 2008 eligible HIV-infected patients from two affiliated clinics accessed Expanded Access Program antiretrovirals of raltegravir etravirine and or maraviroc with optimized background. A NHL case was defined as a pathologically-confirmed tissue diagnosis in a patient without prior NHL developing symptoms after starting newer-class antiretrovirals. Mean change in CD4 and log10 VL in NHL cases compared to controls was analyzed at week 12 a time point at which values were collected among all cases. Results Five cases occurred among 78 patients mean incidence 1000 patient-years . All cases received raltegravir and one received etravirine. Median symptom onset from newer-class antiretroviral initiation was 5 weeks. At baseline the median CD4 and VL for NHL cases n 5 versus controls n 73 were 44 cells mm3 p and vs. log10 p respectively. The mean increase in CD4 at week 12 in NHL cases compared to controls was 13 n 5 vs. 74 n 50 p . Mean VL log10 reduction in NHL cases versus controls at week 12 was .